Hendren Elizabeth M, Reynolds Monica L, Mariani Laura H, Zee Jarcy, O'Shaughnessy Michelle M, Oliverio Andrea L, Moore Nicholas W, Hill-Callahan Peg, Rizk Dana V, Almanni Salem, Twombley Katherine E, Herreshoff Emily, Nester Carla M, Hladunewich Michelle A
Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada.
Division of Nephrology, Department of Internal Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
J Clin Med. 2019 Feb 3;8(2):176. doi: 10.3390/jcm8020176.
A range of women's health issues are intimately related to chronic kidney disease, yet nephrologists' confidence in counseling or managing these issues has not been evaluated. The women's health working group of Cure Glomerulonephropathy (CureGN), an international prospective cohort study of glomerular disease, sought to assess adult nephrologists' training in, exposure to, and confidence in managing women's health. A 25-item electronic questionnaire was disseminated in the United States (US) and Canada via CureGN and Canadian Society of Nephrology email networks and the American Society of Nephrology Kidney News. Response frequencies were summarized using descriptive statistics. Responses were compared across provider age, gender, country of practice, and years in practice using Pearson's chi-squared test or Fisher's exact test. Among 154 respondents, 53% were women, 58% practiced in the US, 77% practiced in an academic setting, and the median age was 41⁻45 years. Over 65% of respondents lacked confidence in women's health issues, including menstrual disorders, preconception counseling, pregnancy management, and menopause. Most provided contraception or preconception counseling to less than one woman per month, on average. Only 12% had access to interdisciplinary pregnancy clinics. Finally, 89% felt that interdisciplinary guidelines and/or continuing education seminars would improve knowledge. Participants lacked confidence in both counseling and managing women's health. Innovative approaches are warranted to improve the care of women with kidney disease and might include the expansion of interdisciplinary clinics, the development of case-based teaching materials, and interdisciplinary treatment guidelines focused on this patient group.
一系列女性健康问题与慢性肾脏病密切相关，但肾科医生在咨询或处理这些问题方面的信心尚未得到评估。肾小球疾病国际前瞻性队列研究“治愈肾小球肾炎（CureGN）”的女性健康工作组，旨在评估成年肾科医生在管理女性健康方面的培训、接触情况及信心。通过CureGN和加拿大肾脏病学会的电子邮件网络以及美国肾脏病学会的《肾脏新闻》，在美国和加拿大分发了一份包含25个条目的电子问卷。使用描述性统计总结了回答频率。使用Pearson卡方检验或Fisher精确检验，比较了不同提供者年龄、性别、执业国家和执业年限的回答情况。在154名受访者中，53%为女性，58%在美国执业，77%在学术环境中执业，年龄中位数为41 - 45岁。超过65%的受访者对女性健康问题缺乏信心，包括月经紊乱、孕前咨询、孕期管理和更年期。大多数人平均每月为不到一名女性提供避孕或孕前咨询。只有12%的人能够使用跨学科妊娠诊所。最后，89%的人认为跨学科指南和/或继续教育研讨会将提高知识水平。参与者在咨询和管理女性健康方面都缺乏信心。需要创新方法来改善对肾病女性的护理，可能包括扩大跨学科诊所、开发基于病例的教材以及针对该患者群体的跨学科治疗指南。
